Presenters DAVE JOHNSON MSW, ACSW fletchergroup.org Project - PowerPoint PPT Presentation

ERNIE FLETCHER,MD Principal Investigator Presenters DAVE JOHNSON MSW, ACSW fletchergroup.org Project Administrator This ¡presenta,on ¡is ¡supported ¡by ¡the ¡Health ¡Resources ¡and ¡Services ¡Administra,on ¡(HRSA) ¡of ¡the ¡U.S. ¡Department ¡of ¡Health ¡and ¡Human ¡Services ¡(HHS) ¡as ¡part ¡of ¡an ¡award ¡ totaling ¡$10.4 ¡million. ¡The ¡contents ¡are ¡those ¡of ¡the ¡author(s) ¡and ¡do ¡not ¡necessarily ¡represent ¡the ¡official ¡views ¡of, ¡nor ¡an ¡endorsement, ¡by ¡HRSA, ¡HHS ¡or ¡the ¡U.S. ¡Government. ¡

To ¡start ¡you ¡on ¡a ¡path ¡to ¡a ¡ Recovery ¡Residence ¡that ¡is: ¡ • ¡Safe ¡ • ¡Effec,ve ¡ • ¡Affordable ¡ • ¡Sustainable ¡ Our Goal Today

AGENDA 1. The Fletcher Group RCOE 2. Providing Scientific and Technical Assistance 3. Recovery Housing Overview 4. Idaho and SUDs 5. Outcomes 6. Recovery Housing in Idaho

To reduce morbidity, mortality, and other adverse outcomes HRSA associated with Substance Use Disorders, Mandate particularly Opioid Use Disorders in rural communities where guidance is needed to address not only the current opioid crisis, but future crises as well.

HRSA TARGETS SURVEILLANCE HOUSING • SUD/OUD screening • Recovery Housing and diagnosis NARR Levels 1-4 INTERVENTION • Fatal and nonfatal • National Recovery • Prevention programs overdoses Housing Directory • Early intervention, • Training Portal • Service availability, especially SBIRT including MAT • Outcomes Portal

OUR PARTNERS

Our DR. TERRY BUNN UK Associate Professor Co-Investigator and KIPRC Director KIPRC works to reduce injury through education, policy initiatives, public health programming, surveillance, risk factor analysis, direct interventions, and evaluation.

KENTUCKY ORIGINS Our recovery expertise began in 2004 Our History when Governor Ernie Fletcher launched Recovery Kentucky—18 recovery residences that have helped thousands of people rebuild their lives while saving millions in taxpayer dollars.

FLEXIBLE Agile and purpose-driven. TEAM-ORIENTED Our Culture Partnerships—federal, state and private sector. COMMUNITY EMPHASIS Local understanding, buy-in, and support.

NON-COMPETITIVE Who gets the credit? PARTNERING • SAMHSA’s BRSS-TACS Collaborating • NIH HEALing Communities • State NARR Affiliates • HHS’s Findtreatment.gov To Integrate Silos INTEGRATING WITH STAKEHOLDERS Integrate with community efforts, not rebuild.

A NATIONAL AND TARGETED REACH We work in rural communities in Montana, Our Focus Idaho, Washington, Oregon, Kentucky, Georgia, West Virginia, Ohio, and other rural Recovery Housing communities as requested VULNERABLE POPULATIONS We focus on the homeless and those with SUDs involved with criminal justice.

EVERYTHING FROM “ SOUP TO NUTS” Fletcher Group • Provide scientific and technical assistance Technical • Disseminate Best Practices Assistance to rural communities • Help sustain all four NARR levels of Recovery Housing

Dedicated to expanding access to quality Evidence-Based Recovery Housing for all populations, particularly the most vulnerable. ONE VOICE We work hand-in-hand with NARR and other partners to ensure a nationally unified voice for Recovery Residences.

TESTIMONIALS ¡ “I really liked the recovery dynamics. They explained the disease. They show a lot of love and teach you how to love yourself and others.” “The program deals with my addiction in a productive way. It gives me structure and the tools I need to stay sober.”

CHAOS Recovery Housing is an unregulated industry prone to fraud and abuse. The CONFUSION Desperate families spend thousands of Challenges dollars with little to show. LACK OF RESOURCES Rural communities lack the funds, providers and resources to respond.

RECOVERY ¡RESIDENCES ¡IN ¡THE ¡CONTINUUM ¡OF ¡RECOVERY ¡ NARR Levels Of Support

RECOVERY ¡RESIDENCES ¡IN ¡THE ¡CONTINUUM ¡OF ¡RECOVERY ¡ Four Distinct Levels

THE NEED FOR A HOLISTIC APPROACH • In 2018 over 68,000 overdose Establishing deaths were reported, with 60% resulting from opioid overdoses. A Recovery • Many occurred soon after Ecosystem release from prison. • A holistic approach takes a community view to address individuals impacted by substance use disorders.

HIGHER RATES HIGHER COSTS Challenges of SUD incidence, morbidity, Long-distance travel to overdose occurrence and facilities adds significantly to mortality. already high costs. Unique To Rural FEWER GREATER RESOURCES STIGMA Areas Doctors diagnosing SUDs are Smaller rural communities less likely to have the may experience less privacy resources and training for and, as a result, more social follow-up care. stigma.

State efforts Bring down silos and and strategy inform RH strategies Top Down Versus Local Integrate with community Bottom Up existing efforts efforts “All ¡poli(cs ¡are ¡local.” ¡ Tip ¡O’Neill, ¡Speaker, ¡House ¡of ¡US ¡Representa8ves, ¡1977-­‑1987 ¡

IDAHO CHALLENGES

IDAHO TARGET COUNTIES Payette (23,551) Washington (10,161) TOTAL: 33,712

OREGON TARGET COUNTIES Baker (16,006) Grant (7,176) Harney (7,329) Malheur (30,725) Umatilla (77,516) Union (26,461) Wallowa (7,081) TOTAL: 171,271

54% OF THE HOMELESS HAVE A SUBSTANCE USE DISORDER (2015) Source: Homelessness in Idaho 2015 Point In Time Count

HIGHER RATES HIGHER COSTS Unique of SUD incidence, morbidity, Long-distance travel to Rural overdose occurrence and facilities adds significantly to mortality. already high costs. Challenges FEWER GREATER RESOURCES STIGMA Doctors diagnosing SUDs are Smaller rural communities less likely to have the may experience less privacy resources and training for and, as a result, more social follow-up care. stigma.

VULNERABLE DISTRUST More Native Americans meet Of mainstream institutions Unique the diagnostic criteria exacerbated by treatment for SUD than any other ethnic protocols that may be Cultural or minority group. culturally insensitive. Challenges GEOGRAPHY COMPLEXITY Widely dispersed facilities and Areas lacking social services the technicalities of insurance and education are also more can present additional likely to interact with the problems. criminal justice system.

NATIVE AMERICAN CHALLENGES

12.3% OF AMERICAN INDIANS CURRENTLY USE ILLICIT DRUGS (compared to 9.5% of whites, 8.8% of Hispanics, and 10.5% of African Americans) Source: National Survey on Drug Use and Health

#1 HIGHEST INCREASE IN OVERDOSE MORTALITY IS AMONG NATIVE AMERICANS Source: Centers for Disease Control and Prevention (specifically drug- and opioid-involved overdose mortality) Morbidity and Mortality Weekly Report, Dec. 21, 2018

2.7 TIMES HIGHER MORTALITY RATE AMONG NATIVE AMERICANS COMPARED TO WHITES Source: Centers for Disease Control and Prevention (In Washington State 2013-2015; nationwide data unavailable) Morbidity and Mortality Weekly Report, Dec. 21, 2018

4.1 TIMES HIGHER HEROIN-INVOLVED OVERDOSE MORTALITY Source: Centers for Disease Control and Prevention (2013-2015) Morbidity and Mortality Weekly Report, Dec. 21, 2018

40% ESTIMATED PERCENTAGE BY WHICH NATIVE AMERICAN MORTALITY RATES ARE UNDERESTIMATED Source: Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, Dec. 21, 2018

NOT IN MY BACKYARD? REMIND OBJECTORS WHO ADDICTED PEOPLE ARE— YOUR NEIGHBORS, YOUR FRIENDS, YOUR FAMILY.

OUR FACILITIES

Women's Addiction Recovery Center in Henderson W.A.R.M. • 28,757 county residents • The first recovery facility in the state of Kentucky • Frequently accepts residents from Tennessee

MISSION Provide hope to homeless women suffering from alcoholism and drug addiction.

W A R M R e s i d e n c e s I I 32 units Recovery Center WARM Residences I 32 units C o m m u n i t y C e n t e r

Knott County, Kentucky HICKORY HILLS 15,126 county residents RECOVERY CENTER Overdose Rate: 44 per 100,000 The CDC’s 17 th Most Vulnerable County

Peer-to-peer self-help including the 12-step AA PROGRAM program used to develop the personal accountability, self-actualization, and empowerment needed to re- enter into relationships, work, and society.

SOS—SAFE OFF THE STREETS PHASE ONE MT—MOTIVATIONAL TRACK PHASE ONE—TRANSITIONAL PHASE

TESTIMONIALS What Our Clients Say

“The program changed me and I’m now a peer mentor. I know about this disease better and have the tools to stay sober.” “They truly, honestly care about me and want me to have a fruitful and productive future.”

“It changed my life. I learned from others and got a lot out of the program.” “They’re personal and really care about you while you’re there and when you go home.“